Finding the right place for a struggling child isn’t easy

From the Bend Bulletin, November 27, 2009

It’s been difficult to read recent news articles about Mount Bachelor Academy , the private therapeutic boarding school in Crook County ordered closed by the Oregon Department of Human Services earlier this month. If discussions in my office are typical, reports of what allegedly went on there leave many of us wondering just what parents of the children at the school were thinking.

Though she’s the first to tell you she cannot say for sure, Sondra Marshall, a psychologist who focuses on children and adolescents, can make a good guess. Most likely, Marshall says, parents were at the end of their rope, desperate and worried that a child might hurt themselves or someone else.

Yet the decision to place a child in a residential treatment program or therapeutic boarding school raises all sorts of questions of its own. Probably most important, how do parents go about selecting a program that will keep their child safe and return him in better shape than when he left? Most parents aren’t licensed psychologists with Ph.D.s, as Marshall is. Most aren’t even school counselors with master’s degrees or physicians with a broad range of medical contacts. Most are like you and me, concerned parents worried about a child and not sure how to proceed.

One key, Marshall says, is to hunt for a program that takes care of the child but looks after the needs of the family as well. Children with severe problems don’t develop them in a vacuum, and a program that leaves the family out of a treatment plan may well send a child back to the very situation that was a big part of his problem in the first place.

“A good program will work with the whole family system,” she says. “A lot of times it’s the whole family system that needs treatment.”

In many larger communities, treatment needs can be filled without having to send a child far from home. Here, unless a child happens to be on the Oregon Health Plan, the choices are, like Mount Bachelor, so expensive as to be out of reach for many without borrowing. Mount Bachelor, as one example, charged about $76,000 annually to treat a child.

Even with the financial resources in hand, selecting a school is no easy matter. The National Association of Therapeutic Schools and Programs, one of several similar agencies, lists nearly 200 options around the United States to choose from.

Most families hire an educational consultant to help narrow the field. But, Marshall says, even that can be tricky. A consultant who doesn’t have the clinical background to judge programs may not be qualified to help you pick the one that fits your child and family.

Marshall suggests asking potential consultants questions about their clinical background. Ask for references, she says, and then check them out. Find out what other parents who have used their services think. And don’t be afraid to discuss finances. What sort of retainer does a consultant require, and what does it get you?

After that, finding a good program is not unlike finding a good day care center for an infant or small child. That means check it out, in as much detail as you can.

Marshall looks for some specifics. First, of course, she says you should visit any school you’re interested in. You’ll want to know about their clinical programs and staff. Do they have experts in substance abuse? Issues surrounding adoption? Serious mental health problems? Is the staff well educated? Are there enough members to do the job with the education to actually do it? How are medications handled?

Those questions answered, get specific. Find out just what a program entails. Is there one-on-one therapy? Group therapy? What’s expected of parents, and how can those expectations be met if a school is several thousand miles away from home? What kind of results has the program achieved — and here, she says, get specific. Ask for outcomes and data to support them.

And don’t forget the school part of the program. No parent wants to send a kid away for treatment only to discover the educational component was so weak he cannot get into the college he’s always dreamed of.

As is true when checking out a day care facility, be wary of programs, people and settings that make you uneasy. You wouldn’t put a toddler in a day care facility that wasn’t willing to allow you to drop in at random, and while you cannot do that at a therapeutic school, you should feel comfortable about the program, and those who run it should be forthright about what they do and why they do it.

There were warnings of problems at Mount Bachelor that should have tipped parents off, including the state’s investigation that led to the school’s closure. Even if you’re desperate, don’t ignore such signs. After all, you’re trying to get your child help, not make his problems worse.